title: Presentation, management, and outcomes of ischaemic heart disease in women.
abstract: Scientific interest in ischaemic heart disease (IHD) in women has grown considerably over the past 2 decades. A substantial amount of the literature on this subject is centred on sex differences in clinical aspects of IHD. Many reports have documented sex-related differences in presentation, risk profiles, and outcomes among patients with IHD, particularly acute myocardial infarction. Such differences have often been attributed to inequalities between men and women in the referral and treatment of IHD, but data are insufficient to support this assessment. The determinants of sex differences in presentation are unclear, and few clues are available as to why young, premenopausal women paradoxically have a greater incidence of adverse outcomes after acute myocardial infarction than men, despite having less-severe coronary artery disease. Although differential treatment on the basis of patient sex continues to be described, the extent to which such inequalities persist and whether they reflect true disparity is unclear. Additionally, much uncertainty surrounds possible sex-related differences in response to cardiovascular therapies, partly because of a persistent lack of female-specific data from cardiovascular clinical trials. In this Review, we assess the evidence for sex-related differences in the clinical presentation, treatment, and outcome of IHD, and identify gaps in the literature that need to be addressed in future research efforts.
authors.affiliation: Emory University Rollins School of Public Health and School of Medicine, USA.
authors.forename: Viola
authors.initials: V
authors.lastname: Vaccarino
authors.forename: Lina
authors.initials: L
authors.lastname: Badimon
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
authors.forename: Cor
authors.initials: C
authors.lastname: de Wit
authors.forename: Maria
authors.initials: M
authors.lastname: Dorobantu
authors.forename: Olivia
authors.initials: O
authors.lastname: Manfrini
authors.forename: Akos
authors.initials: A
authors.lastname: Koller
authors.forename: Axel
authors.initials: A
authors.lastname: Pries
authors.forename: Edina
authors.initials: E
authors.lastname: Cenko
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bugiardini
mesh_terms: D000368:Aged; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D016387:Women's Health